Value of repeat cranial computed axial tomography scanning in patients with minimal head injury

Am J Surg. 2004 Mar;187(3):338-42. doi: 10.1016/j.amjsurg.2003.12.015.


Background: Patients with minimal head injury (MHI) and a cranial computed axial tomography (CAT) scan positive for the presence of intracranial injury routinely undergo a repeat CAT scan within 24 hours after injury. The value of this repeat cranial CAT scan is unclear in those patients who are neurologically normal or improving.

Methods: A retrospective analysis of all adult patients admitted to a level-1 trauma center with MHI and a positive cranial CAT scan during a 32-month period was performed. The need for neurosurgical intervention after repeat CAT scan in patients with a persistently normal or improved neurological examination was recorded.

Results: One hundred fifty-one patients had a persistently normal or improved neurological examination, but none of these patients required neurosurgical intervention after the repeat cranial CAT scan.

Conclusions: A persistently normal or improving neurological examination in a patient with MHI appears to exclude the need for neurosurgical intervention and thus a repeat cranial CAT scan.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Cohort Studies
  • Confidence Intervals
  • Craniocerebral Trauma / diagnostic imaging*
  • Craniocerebral Trauma / surgery
  • Critical Care / methods
  • Female
  • Follow-Up Studies
  • Glasgow Coma Scale
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Neurologic Examination
  • Neurosurgical Procedures / methods
  • Probability
  • Retrospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Time Factors
  • Tomography, X-Ray Computed / methods*
  • Trauma Centers
  • Triage / methods*